Procedure Uses Magnetic Therapy To Relieve Symptoms

June 30, 2006|By DENNIS O'BRIEN | DENNIS O'BRIEN,SUN REPORTER

As a mother of five who sang in a church choir and ran two businesses near Philadelphia, Garrett Aguilar considered herself happy.

But she also knew that depression ran in her family. When she began to show symptoms four years ago, her doctors tried a variety of standard treatments - six months on Prozac, a week on Wellbutrin and a year on Zoloft. Nothing could restore her spirits.

"I just found myself getting deeper and deeper. It got so bad I couldn't get out of bed," said Aguilar, 55, of Berwyn, Pa.

Then a friend mentioned an experimental treatment that sounded almost like science fiction. Called TMS - for transcranial magnetic stimulation - it attacks depression by applying a magnetic field to the brain.

She enrolled in a TMS clinical trial at the University of Pennsylvania School of Medicine - a site for one of two major TMS studies in recent years. The study was funded by a firm seeking federal approval for the first TMS device specifically designed to treat depression.

If approved, it could offer hope to the 4 million people who suffer from depression but fail to respond to standard therapies or can't tolerate the side effects, said Dr. Mark Demitrack, a psychiatrist and medical director of Neuronetics Inc. of Malvern, Pa.

"There's no question that what's out there now just doesn't work for everyone," Demitrack said.

Researchers have been exploring TMS for two decades, using a technique that can sound bizarre to the uninitiated. The test subject sits in a chair while a scientist places a magnet on his head, then sends magnetic pulses through his skull to "light up" various areas of the brain.

As strange as TMS seems, depression can be so debilitating that patients who fail to respond to other treatments are willing to try almost anything.

That's how bad things were for Aguilar by Christmas 2004, when she found she didn't even have the energy to decorate her house for the holidays - a ritual she always enjoyed. "I was at a point where I felt like I had nowhere else to turn," she said.

After participating in the six-week randomized trial, Aguilar agreed to a follow-up round of TMS treatments. "It kind of tickles your scalp," she remembered.

After a few weeks, she began to improve. These days, she takes a low dose of Lexapro, an antidepressant, and hasn't had a TMS session since March 2005. She credits the magnetic therapy with curbing her depression.

"TMS absolutely changed my life," she said. "It might not work for everybody, but it certainly worked for me."

Researchers are still refining their techniques. They know that by placing the device on different areas of the head, they can make fingers twitch or freeze speech in mid-sentence. There is a small risk of seizures.

But in preliminary studies, TMS has stilled imaginary voices in the heads of the mentally ill and shown promise for treating headaches, post-traumatic stress and obsessive-compulsive disorders.

"It sounds like sci-fi, doesn't it? But I think this is big news," said Dr. Sarah H. Lisanby, a TMS researcher who is director of brain stimulation at Columbia University College of Physicians and Surgeons.

Doctors interested in treating depression aim the magnets at the prefrontal cortex. Other researchers target areas controlling speech, memory or the nerve centers that bring on migraine headaches.

Researchers at Ohio State University Medical Center released a study last week showing a hand-held TMS device placed against the back of the head reduced the pain of migraine headaches. There is no risk of seizures because the device sends out only single - and not repeated - magnetic pulses, said Robert Fischell, the Howard County inventor who developed it. A clinical trial is planned for this year and Fischell hopes to win Food & Drug Administration approval and begin selling the device by mid 2007.

Quieting voices

Last year, scientists at Yale University reported the benefits of applying TMS to brain areas controlling speech perception in 50 schizophrenic patients who were having auditory hallucinations. When researchers focused the magnetic field on what is known as Wernicke's area, the imaginary voices subsided. Their report was published in Biological Psychiatry.

"You can shut off specific brain functions, things like speech or motor control," said Dr. Eric Wassermann, chief of brain stimulation at the National Institute of Neurological Disorders and Stroke, a branch of the National Institutes of Health.

In 1998, after a small number of TMS test subjects reported seizures from repeated pulses, Wassermann published safety guidelines dealing with the frequency and duration of the magnetic pulses used in TMS research.

There remains a small risk of seizure, a risk also found with several depression medications. But Wassermann considers the technique safe enough to practice on himself. He experimented a few years ago by having a fellow researcher target the speech centers of his brain as he was speaking. A few zaps of TMS stopped him from talking in mid-sentence.

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